Predictive biomarkers of biologic therapy response in chronic rhinosinusitis with nasal polyps: a systematic review.

What was studied

This review looked at adults with chronic rhinosinusitis with nasal polyps. These people were treated with biologic drugs, such as dupilumab or omalizumab. The team asked if tests taken before the drug could show who responds. They gathered earlier studies with 489 people in total. They also pooled some of the data in a joint analysis.

What they found

People with high blood eosinophil counts were more likely to respond to the drugs. High meant over 300 cells per microliter, or high as each study set it. They were more likely to feel better on the SNOT-22 symptom score. Their polyp score was also more likely to drop by at least 1 point. Other tests, such as IgE in the blood, gave mixed results across studies. The trust in the evidence was rated low to very low.

What it means for patients

The authors say the evidence so far is of low certainty. Even so, it suggests blood eosinophil count is the most steady sign of response. They say this count is worth more study as a guide. But it needs testing in new studies before use in daily care. Other tests did not give a clear guide in this review.

Why it is not certain yet

The studies observed people as they were treated, not in planned trials. The studies also differed from each other. Some results were not exact enough to be sure. The authors say new studies that follow people forward are needed. A review can only be as good as the studies in it.

Source

Predictive biomarkers of biologic therapy response in chronic rhinosinusitis with nasal polyps: a systematic review.

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